After arthroscopic shoulder surgery

At the time of discharge you will be given instructions as to the type of sling to wear. Exercise may or may not be prescribed depending on the type of surgery you have had. Immobilization (wearing your sling) and protection of a freshly operated shoulder is critical and overuse of the arm can cause a repair to be destroyed. If you have any questions about what it is you are or are not allowed to do with your arm, please contact us before assuming that you are allowed to do certain activities. Do not start any exercises with your arm until the block has worn off and you have control of the arm.

Ice or cryotherapy can be very helpful to reduce inflammation and decrease pain after a shoulder operation. Ice machines are usually dispensed at the time of surgery that sends nearly frozen water into a special device around the shoulder. These machines can work great, but you need to make sure there is ice in the machine and also avoid direct contact with the skin, as frostbite can occur.

The dressing applied at the time of the surgery should be maintained in place for 3 days. After the third full day the dressing may be removed. Clean the incisions with rubbing alcohol using a cotton swab. Simple bandaids can be applied over the incisions at that time. Waterproof bandaids are recommended for showering after day #4. After showering with waterproof bandaids, please remove the waterproof bandaids and clean your incisions again with rubbing alcohol on a cotton swab and apply regular bandaids on top of the incisions.

If there is significant drainage from your incisions, please call Dr. Routman’s office immediately.

Most patients find it most comfortable to sleep in a recliner or a similar type of chair for around 3 weeks. This is not mandatory, however, it tends to be the most comfortable way to a decent night’s sleep. When resting or sleeping, try to keep a pillow behind your elbow and between your body and your forearm. Many people find it very difficult to sleep flat in a bed.

Please let us know if you are not getting enough pain relief. We want to do our best to control your pain in the post-op period, but it is important that you understand we cannot get rid of all of your pain — you will have some discomfort.

If you have received a block for your surgery, it is best to take the pain medication at the onset of return of sensation of any type to the arm. Keep in mind that pain medication can take 30–45 minutes to begin working to become effective, so waiting for the pain to become intolerable prior to taking medication is not a good idea.

The first 72 hours will be strange, the block will make your arm dead and numb and some people do not like the way this feels, but not having the block is worse and this long-acting block has been a game-changer for patients and postop pain after shoulder surgery, so hang in there. Some hand swelling is normal during this time, because it is hard to make a fist and that helps to reduce swelling.

Please see the separate medication instruction sheet which will go over what to take on the morning of surgery and what and how to take after surgery as well.

Some common side effects associated with your pain medication include:

• Nausea and vomiting
• Constipation
• Dizziness
• Dry mouth
• Confusion

Having a small snack such as yogurt before taking your pain medication can help prevent upset stomach.

Ibuprofen is an anti-inflammatory drug, and reduces pain in a different way than the other medication. During the early postop period this can be helpful, but try to steer clear of Ibuprofen after the first week as it can slow the healing of tendon to bone. Use Tylenol instead.

If you experience any other side effects, please notify our office right away. You should not drive while taking narcotic pain medication.

You will be instructed on exercises to perform after your operation. Some procedures require more exercises than others. If you have any questions about which exercises you should be doing, please contact the office. Please do not perform exercises that are painful without speaking to us first. Using ice after exercising for 20 minutes can reduce inflammation and soreness after exercise. Don’t overdo it.

The activity level prior to the first office visit should be discussed with Dr. Routman. I typically recommend only the most sedentary type of activity and things that can be done with the arm safely in a sling. Bicycle riding, rollerblading, jogging and even power walking can result in injury to a freshly operated on shoulder. If you have any specific questions about which activities are safe, please give us a call.

It is not uncommon to have a low grade fever for a few days after surgery. However, if you start to feel sick or have a fever of more than 101 degrees, chills, redness, swelling or pain that seems to be out of proportion to what you would expect, please give us a call. Any drainage with a foul smelling odor from the dressing should be reported to Dr. Routman. Some patients receive antibiotics during and after surgery. The decision as to whether antibiotics would be appropriate after surgery for you is something you should discuss with Dr. Routman, however, most patients do not require antibiotics after surgery.

As a part of your surgical scheduling, a postop appointment has already been made for you. If you do not know when the appointment is, please check the paperwork that you have gotten from us and if you need help, give us a call.

(561) 627-8500

Please bring your surgical photos with you to the office for your post-operative visit so Dr. Routman can go over the details of your operation with you.

It is recommended that you refrain from driving or operating any heavy machinery while taking narcotic pain medication.